CPT: 86825
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Test Details


  • Flow Crossmatch
  • HLA Crossmatch
  • T-Cell and B-Cell Crossmatch


Detection of the presence of antidonor antibodies (HLA) in a potential solid organ recipient, T- and B-cell crossmatch detects the presence of anti-Class I/Class II HLA antibodies in the recipient that would recognize donor-specific antigens. The presence of antibodies against donor HLA antigens is a contraindication for transplantation and could lead to immediate/acute organ rejection.


Although the primary antibodies that are detected by this assay are to HLA, other non-HLA-specific antibodies could cause positive T- and/or B-cell crossmatch. This testing only demonstrates antibodies that recognize donor antigens and cannot distinguish clinical relevant antibodies (eg, complement binding ability) from nonclinical antibodies. This assay only detects the presence of IgG antidonor antibodies and does not detect IgM or other immunoglobulin subclasses.


Presence of antibody bound to human lymphocytes detected by immunofluorescence and flow cytometry

Specimen Requirements


Donor sample: Whole blood; Recipient sample: Serum


Donor sample: 12 mL; Recipient sample: 2 mL

Minimum Volume

Donor sample: 8 mL; Recipient sample: 2 mL


Donor sample: Yellow-top (ACD) tube (solution A or B). Recipient sample: Red-top tube or gel-barrier tube

Patient Preparation


Storage Instructions

Maintain whole blood and serum at room temperature. Donor specimens should be analyzed within 72 hours of collection. Recipient serum may be stored at 4°C for one week or at -20°C indefinitely.

Causes for Rejection

EDTA or heparin tube; hemolysis; clotted specimen; donor samples exceeding 72 hours

Clinical Information

Special Instructions

To schedule this test, you must telephone 800-533-1037, HLA customer service.


Bray RA. Flow cytometry in the transplant laboratory. Ann NY Acad Sci. 1993 Mar 20; 677:138-151. 8494203
Gebel HM, Bray RA, Nickerson P. Pre-transplant assessment of donor-reactive, HLA-specific antibodies in renal transplantation: Contraindication vs. risk. Am J Transpl. 2003 Dec; 3(12):1488-1500. 14629279
Graff RJ, Xiao H, Schnitzler MA, et al. The role of positive flow cytometry crossmatch in late renal allograft loss. Hum Immunol. 2009 Jul; 70(7):502-505. 19364513
Karpinski M, Rush D, Jeffery J, et al. Flow cytometric crossmatching in primary renal transplant recipients with a negative anti-human globulin enhanced cytotoxicity crossmatch. J Am Soc Nephrol. 2001 Dec; 12(12): 2807-2814. 11729251
Organ Procurement and Transplantation Network/Health Resources and Services Administration/ US Department of Health and Human Services. Policy Management. Available at: Accessed June 20, 2014.
Patel R, Terasaki PI. Significance of the positive crossmatch test in kidney transplantation. N Engl J Med. 1969 Apr 3; 280(14):735-739. 4886455
Tinckam, KJ. Basic Histocompatibility testing methods. In: Chandraker A, Sayegh MH, Singh AK, eds. Core Concepts in Renal Transplantation. Springer Publishing; 2012: chap 2.


Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
167160 Allo-Crossmatch by Flow 167191 AlloCrossmatch T-Cell(ALTCELL) 48409-7
167160 Allo-Crossmatch by Flow 167192 AlloCrossmatch B-Cell(ALBCELL) 48390-9

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